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Acoustic Neuroma - Crossref

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Last Updated: 03 May 2022

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Association of proliferative activity and size in acoustic neuroma: implications for timing of surgery

Acoustic neuroma is the most common benign tumor of the cerebellopontine angle, and surgery is still the most common form of therapy. The authors examined proliferative activity of 34 consecutive samples by examining immunohistochemical staining with Ki-67 and proliferating cell nuclear antigen, as well as terminal deoxynucleotidyl transferase-mediated deoxynucleotidyl transferase nick-end labeling to gain greater insight into the dysregulated mechanisms triggering growth of acoustic neuroma. In comparison to tumors larger than 18 mm with high proliferative indices and growth rates, tumors 18 mm or smaller in diameter have lower proliferation indices and growth rates, according to the researchers. Patients with tumors the size of 18 mm in diameter and younger than 50 years of age have an elevated risk of fast-growing tumors as a result of these lesions' enhanced proliferative function.

Source link: https://doi.org/10.3171/jns.2003.98.4.0807


Predictors of hearing preservation after stereotactic radiosurgery for acoustic neuroma

Object Description Many patients with acoustic neuromas have heard function at diagnosis and want to maintain it. Following stereotactic radiosurgery using the Gamma Knife, the researchers of this study investigated tumor control and hearing preservation as they relate to tumor size, image characteristics, and nerve and cochlear radiation dose. Methods Seventy-seven patients with ANs had serviceable hearing and underwent SRS between 2004 and 2007. The median tumor volume was 0. 75 cm 3 - 3, and the median radiation dose to the tumor margin was 12. 5 Gy. At diagnosis, a greater distance from the lateral tumor to the end of the internal auditory canal was associated with improved hearing performance. In 71% of all patients and in 89% of those with GR Class I hearing, serviceable hearing was preserved. A GR Class I hearing, an SDS 80%, an intracanalicular tumor location, and a tumor volume 0. 75 cm 3 were among the key prognostic factors for serviceable hearing preservation. Patients who were exposed to a radiation dose of 4. 2 Gy to the central cochlea had a pronounced improvement in hearing preservation of the same GR class. At 2 years post-SRS, twelve of 12 patients with a cochlear dose had good serviceable hearing at 12 years of age. Conclusions As currently administered, SRS with the Gamma Knife maintains serviceable hearing in the majority of patients.

Source link: https://doi.org/10.3171/2008.12.jns08611


Cerebrospinal fluid leak after acoustic neuroma surgery: influence of tumor size and surgical approach on incidence and response to treatment

This research was designed to investigate the risk of cerebrospinal fluid leakage complicating the removal of acoustic neuroma and determining factors that influence its formation and treatment. A retrospective review of the medical records in which patients with CSF leaks complicating tumor removal were identified was supplemented by a prospective review of prospective patients undergoing acoustic neuroma surgery. The authors found an overall incidence of 10. 7% for CSF leakage in 624 cases of acoustic neuroma. Tumor size had a significant effect on the leakage rate in general and for RS, but not for TL procedures, but not for TL procedures. However, TL leaks were more frequent than RS leaks, and surgical intervention was required more often than RS leaks. The incidence of CSF leakage following TL and RS procedures has remained steady. As nonsurgical solutions for acoustic neuroma are introduced, the issue of CSF leakage is becoming more significant.

Source link: https://doi.org/10.3171/jns.2001.94.2.0217


Patient-assessed outcomes after excision of acoustic neuroma: postoperative symptoms and quality of life

The aim of this investigation was to determine whether the outcomes from the excision of acoustic neuroma vary among patients and have a direct effect on their quality of life. Patients 97 consecutive patients who had undergone acoustic neuroma surgery by the translabyrinthine technique received a questionnaire regarding postoperative signs and the Short Form 36 QOL unit. Lower ratings of social functioning were attributed to more serious balance issues. The patient's facial appearance raises doubts about subjective findings and assessments because of the disparity between his own estimate and self-measurement, as well as the clinician's analysis of the patient's facial health.

Source link: https://doi.org/10.3171/jns.2001.94.2.0211


Results of acoustic neuroma radiosurgery: an analysis of 5 years' experience using current methods

This study was designed to identify tumor prevention and radiosurgery in patients with unilateral acoustic neuroma. Between 1992 and 1997, one hundred ninety patients with previously untreated unilateral acoustic neuromas underwent radiosurgery. For any new facial pain, facial numbness, hearing-level preservation, and testable speech discrimination, 1. 2 2. 6%, 91 6. 6, respectively. In any patient who received a marginal dose of less than 15 Gy, facial pain did not develop. In ten of 141 patients who had decreased hearing after radiosurgery, hearing levels increased. A recent study reveals that a high incidence of tumor control and lower rates of post-treatment morbidity are tied to a continued high rate of tumor control and lower rates of posttreatment morbidity than those reported in earlier studies.

Source link: https://doi.org/10.3171/jns.2001.94.1.0001


Hearing preservation in acoustic neuroma surgery: importance of adhesion between the cochlear nerve and the tumor

In a total series of 63 acoustic neuromas, the authors retrospectively reviewed the evidence of 30 consecutive acoustic neuroma procedures in which hearing preservation was attempted. Only two of 11 patients with severe adhesion were preserved postoperatively, but all 19 patients without severe adhesion were hearing preservation. The presence or absence of extensive adhesion in the region between the cochlear nerve and the tumor may be the most significant prognostic factor for hearing preservation postsurgery.

Source link: https://doi.org/10.3171/jns.2002.97.2.0337


Retrosigmoid removal of small acoustic neuroma: curative tumor removal with preservation of function

Methods Anonymous Patients with small ANs and preserved hearing underwent retrosigmoid tumor removal in an attempt to maintain hearing and facial function by using intraoperative auditory recording of auditory brainstem responses and cochlear nerve compound action potentials. Preoperative hearing levels of the 44 patients were as follows: Class A, 19 patients; Class B, 17; and Class C, 8. The surgical procedure for curative tumor removal with preservation of hearing and facial appearance involved rapid dissection and debulking of the tumor, reconstruction of the internal auditory canal, and widening of the internal auditory canal dura. Long-term follow-up by MRI with Gd administration demonstrated no tumor recurrence, and although the preserved hearing decreased marginally as a result of the long-term postoperative follow-up period, the majority of serviceable hearing remained at the same level as the original hearing. Conclusions As a result of a surgical procedure that needed sharp dissection and internal auditory canal reconstruction with intraoperative auditory monitoring, retrosigmoid removal of small ANs can result in successful curative tumor removal without long-term disease and with high functional results. The researchers conclude that tumor removal should be the first-line management program for younger patients with low ANs and preserved hearing.

Source link: https://doi.org/10.3171/2014.6.jns132471


Intracanalicular acoustic neuroma: early surgery for preservation of hearing

Since the invention of magnetic resonance imaging, characterization of very small acoustic neuromas has become more common. Patients who were not hospitalized have minimal unilateral hearing loss as their only sign. The results of 14 patients with intracanalicular acoustic neuroma were analyzed by type of presentation, pre- and postoperative facial and auditory nerve function, surgical approach, and complications. Eleven of the 14 patients had serviceable hearing preoperatively, and nine of the nine patients remained in this condition postoperatively. By an operation in 12 patients, facial nerve function was still unevented. The likelihood of preserving hearing after surgical excision of intracanalicular acoustic neuroma in patients with serviceable hearing exceeds 80%. Given the relative ease of severe diseases and the possibility of progressive hearing loss in the untreated patient, excision of such small tumors shortly after diagnosis may be the best hope of long-term hearing preservation.

Source link: https://doi.org/10.3171/jns.1993.79.4.0515


Use of intraoperative auditory evoked potentials to preserve hearing in unilateral acoustic neuroma removal

Those with unilateral acoustic neuromas and preoperative speech discrimination scores of 45 percent or more underwent intraoperative monitoring of the electrocochleogram using a transtympanic electrode, and the brain-stem auditory evoked suspicions using scalp electrodes, as well as clinical examination of scalp electrodes. The cochlear nerve was anatomically preserved in 21, and 20 percent of the population had good postoperative facial nerve function. Comparison of tumor size with postoperative findings was as follows: one of three patients with 1-cm tumors, two of eight with 1. 5-cm tumors, two of eight with 2- to 2. 5-cm tumors, two of six with 2-to-2. 5 cm tumors, two of six with tumors, and one of four with tumors of 3 cm or more. Patients with 1. 5-cm tumors had discrimination scores of less than 35%, and one patient with a 2-cm tumor had only sound perception. N-1 had been missing or reduced in almost every patient with no hearing, but the CM was absent or reduced.

Source link: https://doi.org/10.3171/jns.1984.61.5.0938


Acute hearing loss following fractionated stereotactic radiosurgery for acoustic neuroma

Following fractionated stereotactic radiosurgery for acoustic neuroma, two cases of acute hearing loss have been reported. Both patients had neurofibromatosis type 2 and were treated with a peripheral tumor dose of 21 Gy administered in three fractions with a minimum interfraction interval of ten hours. One patient who had previously undergone surgical resection of the treated tumor presented with only rudimentary hearing in the treated ear secondary to a drastic decrease in hearing prior to treatment.

Source link: https://doi.org/10.3171/jns.1998.89.2.0321

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions